595 NE 96 St (4)M AMII � nCDRIES V[1LLASE
BUILDING INSPECTION DEPARTMENT
APPLDATO N O° B M Ol,DON S PCG°3MOT
0
0
d0S# 350
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
'ing or other structure herein described This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Date ---- ...... d 5__- 19.72.
Owner's Name and Address... Zan .SCAiniZtt No. 5775 _. __- Street Cot i.1.4 Ave.--
Registered Architect and /or Engineer... _
Name and address of licensed contractor_ `,�cbv1.!S. A-9r COm:14'Ai.onvi.ng. Corp.. 4234 S,W, 75 AV e,.
Location and legal description of lot to be built on: /r�
Lot. Ocg Block qq _ Subdivision__.. / S :
Street and Number where work is to be done 595 n, C. 96 S see t
State work to be done and purpose of building (by floors)__ .9n4 tai QLe— One 32 ton. cen -tray Ca ter` ConcliA ..on.t,ng-
a4. 61-town. on _ p , -
and for no other purpose.
New Building -._ -. Remodeling__ ___...._ Addition Repairs. _._ No. of Stories
To be constructed of Kind of foundation..- Roof Covering__.
1 825. 00
Estimated Total cost of improvements $ Amount of Permit $ 8 x.00
Zone cubage required plan Cubage____ _.
Distance to next nearest building______ _ _ ________ Size of Building Lot
Maximum live load to be borne by each floor._.
I hereby submit all the plans and specifications foi said building. All notices with reference to the building and its construction may
be sent to- .Bastba.ra___12v4.6.___ . 42.34:. 75 Ale., 226 -8 361
The undersigned applicant for this building pennit dot hereby certify that he understands and accepts his obligations as an. employer
of labor under the Florida Workmen s Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subc tractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks -. - -- (Signed) ....
Disapproved _ pp QQ / _ Date
(Signed) ___W e6 .Lot- _
uilding Inspector
STATE OF FLORIDA,
COUNTY OF DADE. d ss.
Before me, thc undersigned authority, a notary public, duly authorized to administer oaths and take a.kaowledgments, personally ap-
peared
and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true. / �
Permit No 43 •' Date .21 _1_�.- ___ Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires._
PLANNING BOARD__ __ . DATE
Chairman _ _ Member
Member Member
Member _ Member
Council Approved _ _.. _ Date Disapproved
to me well known,
Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.